This report from the Williams Institute summarizes the results of a detailed survey with thirty-four employers about their transition-inclusive health benefits plans for transgender employees, how much these plans have cost them, and what, if any, benefits they receive from providing their transition-inclusive plans. These employers report zero or very low costs and yet substantial benefits, for them and their employees alike, when they provide transition-related health care coverage in their employee health benefit plans. A majority of these employers reported that they would encourage other employers to add the coverage, and none would advise against it.

Key findings from the survey include:

• Eighty-five percent (85%) of the 26 employers that provided information on costs of adding coverage to their existing health benefits plans reported no additional costs to add the coverage.
• Two-thirds of the 21 employers that provided information on actual costs from employee utilization of the coverage reported zero actual costs due to utilization.
• Based on the experiences of surveyed employers, 1 out of 10,000 employees (among employers with 1,000 to 10,000 employees) and 1 out of 20,000 employees (among employers with 10,000 to 50,000 employees) will utilize transition-related health benefits annually when they are available.
• The type, number, and cost of services accessed by individuals will vary, yet as described above, the costs of these benefits, if any, are very low, as is the utilization of the benefit.

These findings are consistent with prior research that has shown employers generally benefit from providing LGBT-inclusive workplace policies. Survey participants for this study were all employers known to provide transition-related health care coverage for employees through their health benefits plans.